With attention surrounding access to care often focusing on provider recruitment efforts, it can be easy to overlook the many levels of work that bolster those efforts in numerous ways. One such effort is the federal Health Professional Shortage Designation (HPSA) process, administered by the Health Resources and Services Administration (HRSA). This involves a closely integrated partnership among Michigan Health Centers, Michigan Primary Care Association, the Michigan Department of Community Health, and HRSA.
Working fervently up to the end of the calendar year to lock in federal Automatic-Facility HPSA designation scores, HRSA re-scored nine Michigan Health Centers from all regions of the state in the final weeks of 2013. The Automatic-Facility HPSA score is calculated by taking many factors into consideration, and while they vary slightly across the health disciplines, each use the common criteria of population-to-provider ratio, percent of population with incomes below 100% of the federal poverty level, and the travel time or distance to the nearest source of care. For primary care, the additional criteria used for determination is infant mortality or low birth weight rate. For dental care, the additional criteria is the percent of population with access to fluoridated water, and for mental care, the additional criteria used in determination of score is the youth or elderly ratio, as well as substance abuse and alcohol abuse prevalence.
The re-scoring process resulted in positive increases for each of the organizations. Having a federal Automatic-Facility HPSA designation allows a Health Center to apply for approval to have one or more delivery sites participate in student loan repayment programs through the National Health Service Corps (NHSC) and/or NURSE Corps sponsored by HRSA.
For these nine Michigan Health Centers, the average score increases for primary, dental, and mental health care were 7, 9, and 4, respectively. These increased scores mean increased competitiveness for NHSC and NURSE Corps site approval. Along the same lines, six of the nine Michigan Health Centers are considered in Tier 1 ( a score of 14 or higher) for placement in the dental and mental health disciplines, making them eligible for the max contribution level for the NHSC and NURSE Corps loan repayment program for practitioners committing to two years of service.
Additionally, eight of the nine Health Centers saw a score increase of five or greater in primary care. For dental care, five of the nine received score increases of greater than 10, while two other Health Centers received a five-point score increase. In the mental health discipline, despite overall slighter score increases, two Health Centers received increases greater than five, while the remaining Health Centers saw increases ranging from one to four points.
With the National Health Service Corps and NURSE Corps loan repayment program application cycles now open for Fiscal Year 2014, news of the score increases comes at a perfect time. The NHSC application cycle is open through March 20, and the NURSE Corp application cycle through February 27.